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Can Bynum make similar recovery as John Wall?

PHILADELPHIA — John Wall sat in the corner of the visitors' locker room before a game at the Wells Fargo Center late last month, heavy wraps keeping heating pads affixed to his knees. It had been 2½ weeks

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PHILADELPHIA — John Wall sat in the corner of the visitors' locker room before a game at the Wells Fargo Center late last month, heavy wraps keeping heating pads affixed to his knees.

It had been 2½ weeks since Wall made his long-awaited season debut with the Washington Wizards and nearly seven weeks since Dr. David Altchek injected his ailing left knee with Synvisc-One, a compound that lubricates and cushions the joint, relieving osteoarthritis pain for up to six months.

Andrew Bynum visited that very same doctor, who administered those very same injections, the very next day.

Wall and Bynum, as it turns out, seem to have a lot in common.

Both the Wizards point guard and Philadelphia 76ers center entered the season as supposed centerpieces of their teams, and both missed more time than expected with bone and cartilage damage in their knees.

Wall, the first draft pick in 2010, sat out the first 33 games. Bynum, meanwhile, has yet to practice or play since the Sixers acquired the 7-foot, one-time All-Star from the Los Angeles Lakers in a four-team trade in August. Bynum has missed 51 games and while he recently said he hopes to make his Sixers debut by the end of this month, that appears unlikely to happen. He may not even play at all this season.

Bynum's agent has prohibited Altchek from publicly discussing his client's condition. And the Sixers, who originally said Bynum would be ready for the season opener on Oct. 31, have declined to comment on a series of reports in The News Journal in November, when one of the top knee surgeons in the country surmised that Bynum's condition was likely to keep him sidelined until late March at the earliest, and possibly cost him the entire season. Less than a week after the articles were published, Sixers general manager Tony DiLeo announced that Bynum was out indefinitely.

Although Wall and Bynum may not have suffered the exact same injury or extent of damage, the same tissues were affected and they shared a common goal – to ensure the stability of their knees before returning to play pro basketball.

What can we learn about Bynum's recovery process by examining Wall's experience?

Perhaps a great deal.

Timing is everything

Both Wall and Bynum were diagnosed with their injuries in September – Wall with a "stress injury" to his left knee cap, Bynum a bone bruise in his right knee. Both, at one point, were aiming to return to action around mid-December. Both missed that deadline and later divulged they also had deteriorated cartilage.

Both were examined and treated by Altchek, an orthopedic surgeon at the Hospital for Special Surgery in New York. Both said they expected to play this season in one breath, but in the next conceded that missing the full season remained a possibility.

Ten weeks passed between the time Altchek initially diagnosed Wall's injury on Sept. 27 and when the point guard received his most recent Synvisc injection on Dec. 14. Wall joined his teammates in limited contact drills exactly three weeks later, on Jan. 4. He made his season debut eight days after that, on Jan. 12, 29 days after receiving the shot and nearly 16 weeks after Altchek's diagnosis.

"I just thanked God, I prayed on it, kept doing my thing and working out, and it just healed in the right way," Wall said. "All I asked for for Christmas was, all I wanted was to play basketball. And basically my Christmas wish came true."

Bynum was diagnosed with a second injury, a "mirror issue" in his left knee, after a piece of cartilage broke off and the joint swelled after he went bowling on Nov. 10. Twelve weeks passed between the time Altchek diagnosed that injury and when Bynum received his most recent Synvisc injections on Jan. 31 – or two weeks longer than it took Wall to get to that point in his rehab.

If Bynum were to follow Wall's exact post-injection schedule, he'd join his teammates in practice on Thursday and make his Sixers debut in less than two weeks from today – at home against Golden State on March 2 – with 26 games remaining in the regular season.

That's the apparent best-case scenario.

But is that timetable reasonable?

Shooting up the knee

Wall's injured right knee responded more favorably than Bynum's left knee after receiving the most recent Synvisc injections.

"After I got my couple shots, they said just let it heal and give it a week and see if you can do anything," Wall said. "And one day I just felt good. I did one leg squat that I couldn't do the entire time, and I was like, 'Well, let's just go test it out, see how it feels.' So I went with my trainer, I did a lot of defensive slides and jumping up and down and running full speed and cutting. And he's like, 'That's good, you got one day out of the way. See how it feels tomorrow. See if you can go three or four days in a row.' And every day I just kept going and going and it helped me get to where I am now."

Wall is 22 years old and 195 pounds; Bynum is 25 and 305 pounds – meaning the Washington point guard's knees have far less wear and tear and weight to support than Bynum's joints.

Bynum said his injections "didn't help that much, to be honest," and admitted that after two days of practicing defensive slides, dunking, full-court layups and post ups, he was forced to reduce the intensity of his workouts after experiencing "a lot of pain" in his left knee. He's also still experiencing a locking sensation caused by loose cartilage and a range of motion issue in the joint.

Bynum said his right knee feels "phenomenal," but that joint, which he injured first, has had as many as two additional two months to heal.

Bynum also has yet to practice shooting against live defenders. Sixers coach Doug Collins and DiLeo have both said that once Bynum advances to 1-on-1 shooting drills, they expect him to slowly build toward playing 2-on-2 before taking part in full 5-on-5 scrimmages. Bynum previously said that once he progresses to full practices, he thinks he'll need between 10 days and two weeks to get into game shape.

Earlier this month, DiLeo cast doubt on that assertion.

"[Bynum] said in the past he thought it would be 10 days to two weeks, but there's a lot that goes into it," DiLeo said. "We've been through this long process. We don't want to take any shortcuts now. We want to make sure that when he comes back, he is healthy and he can continue at that time."

Still rusty

Wall, whose Wizards did not make the playoffs last season, had an 8½-month layoff between playing in NBA games.

In 18 games this season, including 11 starts, Wall is averaging 14.7 points, 7.3 assists and 3.2 rebounds in 28.8 minutes per game. Those are all career lows.

Wall spoke with The (Wilmington) News Journal before the Wizards' loss to the Sixers on Jan. 30, when he scored nine points on 3-for-12 shooting from the field. He also recorded five rebounds, six assists and five turnovers in what was then a season-high 32 minutes. It was his 11th game back.

But while Wall has struggled to regain his form, his impact has been indisputable. Washington has a 10-8 record since Wall's return. It went 5-28 without him.

Bynum averaged 18.7 points and 11.8 rebounds in 35.2 minutes per game last season, all career highs. But even if he does return to the court sometime over the final eight weeks of this season, Wall's struggles these last five weeks indicate that while Bynum's presence may improve the Sixers' fortunes, he's unlikely to post anywhere close to the statistics that made him an All-Star a year ago.

Too little, Too late?

Bynum, making $16.9 million in the final year of his contract, is an unrestricted free agent this summer. He would like nothing more than to get on the court and play significant minutes to prove he's healthy.

But if Bynum does return to the court this season, he's sure to either struggle to regain top form, or worse, reinjure himself. Either scenario could drive down his price on the open market, where he's hoping to land a long-term deal and nine-figure pay day.

The Sixers, meanwhile, are a longshot to make the playoffs this season and have a better grasp of Bynum's condition than any other team in the league. They're also able to offer Bynum a longer contract and more money, should they choose to do so.

If the Sixers believe Bynum can fully recover from his knee injuries and be productive for years to come, might they simply shut him down for the rest of this season out of an abundance of caution? Why try to sell a few extra tickets at the expense of potentially re-aggravating the injury? Why have him try to play through pain? Why not let the injuries heal completely?

If the Sixers do not attempt to re-sign Bynum, he may be in trouble, because if the team that knows the most about his condition decides to let him walk, other teams may be less inclined to offer a max deal.

Questions abound. And there's an awful lot of money hanging in the balance.

What advice would Wall offer Bynum?

"One thing I can say is, as a young person, I looked at it like I have a long career ahead of me, so I want to make sure everything is right," Wall said. "But just love the game and know that you're blessed to play. Because I could have been out a year. And you kind of realize, well, what if my career is over? You see how easy it can go away and how fast it can come, and just enjoy every moment you play out there, every second, every minute."